The September 2014 CPT® Assistant is brimming with recent coding updates and coding tips for deciding when to report fluoroscopy separately. Find out how the CPT® 2015 code set will impact bundling of intrathecal contrast administration via lumbar injection and myelographic radiologic S & I. The issue also briefs you on how to append modifier 59 to computed tomography of the spine with contrast if the provider performs CT subsequent to a myelogram on the same patient the same day.
Reviewing the latest issue will also improve your understanding of how to report an anogenital examination. To get spot-on guidance, simply type a code or keyword into SuperCoder.com’sCode Connect to see the September article that suits your needs:
- Anogenital Examination: 99170
- Fluoroscopy Codes: 76000, 76001, 71023, 71034, 36597, 64581, 49440, 49441, 49442, 49446, 49450, 49451, 49452, 49460, 49465, 64561
- ICD-10-CM “Z” Codes
- Myelography and Injection Procedure Codes : 72240, 72255, 72265, 72270, 62284, 62270, 61055, 72126, 72129, 72132
The latest selection of CPT® Assistant FAQs also provides guidance for a variety of areas. Find authoritative answers in a snap by looking for these codes and topics on Code Connect:
Review guidelines on how to code when the diagnosis isn’t definite.
Implementation of ICD-10 may have been deferred to October 2015, but the Centers for Medicare & Medicaid Services (CMS) has stepped up guidance to help you prepare for the new diagnosis coding system. Recently the agency released a transmittal that should help you understand how you’ll report these codes when insurers start requiring them next year.
CMS issued Transmittal 3020 on Aug. 8, and it announces revisions to the official ICD-10 Coding Guidelines which put them more in line with the current ICD-9 rules. For example, CMS revised the ICD-10 regs to now say, “Do not code diagnoses documented as ‘probable,’ ‘suspected,’ ‘questionable,’ ‘rule out,’ or ‘working diagnosis’ or other similar terms indicating uncertainty. Rather, code the condition(s) to the highest degree of certainty for that encounter/visit, such as symptoms, signs, abnormal test results, or other reason for the visit.”
Question: We’re getting denials when we bill a blood glucose test with 82962. The payer says that the test isn’t payable under contractual agreement. Is this the correct code?
Don’t forget the ‘Five A’ strategy in your documentation.
When CMS established code G0447 in 2011, Part B practices were thrilled to have a way to report obesity counseling. However, in the three years that have passed since the code debuted, several issues have cropped up that plague these claims—and you should know what they are if you want to collect for your services.
Background: You can report G0447 (Face-to-face behavioral counseling for obesity, 15 minutes) if your patient has a body mass index (BMI) of 30 kg/m2 or higher and you perform obesity counseling. Medicare will reimburse you for one visit per week for the first month and one visit every other week between months two and six. In addition, if the patient loses 6.6 pounds during the first six months, he is eligible for an additional visit every month for months seven through 12.
Focus on Physician Records
Documentation of your provider’s role is crucial.
Postoperative pain control is a standard part of care for some patients, such as those who have arthroscopic shoulder surgery. Being reimbursed for your pain management specialist’s service isn’t automatic, however, so remember some key points before submitting a separate claim for the injection or catheter placement.
1. The injection or catheter placement must be administered by a different physician than the surgeon who performed the surgery. You won’t have any problem meeting this criterion, but it’s still good to be aware of the guidelines.
2. Your provider should complete a separate procedure report for the post-op pain management procedure.
You’ll need more info in 2015.
When your pathologist diagnoses an adenomatous polyp submitted from a colonoscopy, you’ll need to know much more information to choose the proper ICD-10 code.
Make sure you train your pathologists to document the proper details so you can properly code these cases when ICD-10 goes into effect on Oct. 1, 2015.
From One to Many
You just need one code for adenomatous colon polyp under ICD-9: 211.3 (Benign neoplasm of colon).
Question: Patient was about 6cm and began to have decelerations into the 80’s. They decided to perform an emergency C-section. Because the fetal head was wedged tightly into the pelvis, the ob-gyn had great difficulty in trying to extract the baby. Several physicians attempted to deliver it without success. The incisions, both uterine and skin, were extended into a “T’ shape. Then, they were finally able to get the baby out. When all was said and done, the fetus had a femur fracture. Fetal weight was 6lbs 14oz.
What ICD-9 code would be appropriate for this scenario, aside from the fetal heart decelerations?
HHS collected millions in HIPAA penalties in recent years.
HIPAA breaches caused by laptop thefts are on the rise, new HHS reports show. Are you doing all you can to avoid risk in this area?
Two recent reports to Congress from the HHS Office for Civil Rights, mandated by the Health Information Technology for Economic and Clinical Health (HITECH) Act, cover calendar years 2011 and 2012.
A breach notification report provides an overview of the breach notification requirements, while a report on the HIPAA rules summarizes complaints HHS has received of alleged violations of HITECH and the HIPAA Privacy and Security Rules, according to OCR.
During 2011 and 2012,
Specific documentation of stenosis and insufficiency will simplify finding the proper code.
When you start using ICD-10 codes in place of ICD-9, your nonrheumatic pulmonary valve disorder code choices will multiply by five. But a little prep work will make choosing among the more specific codes easy to do.
- 424.3, Pulmonary valve disorders
The August 2014 CPT® Assistant features the diagnostic audiology test codes that require use of calibrated electronic equipment. You’ll get clarification on the codes for audiologic function tests that you can report separately, or with E/M services, and get the facts on use of modifier 52 to report the services. Not sure where certain tests fall in the code range? The issue also presents the audiology test codes that enable the provider to identify the degree or type of hearing loss, assess the abnormal growth of loudness perception, detect defects in adaptation to sound, and evaluate the devices related to hearing.
Other topics this CPT® Assistant covers include reporting time based codes, visual evoked potential coding, and much more. Put SuperCoder.com’s Code Connect code and keyword search to good use to deepen your understanding of these topics:
- Audiologic Function Tests : 92550-92597, 92620-92625, 99201-99205, 99211-99215, 99241-99245, 0208T-0212T
- Evaluation and Management (E/M) Services Guidelines
- ICD-10-CM Diagnosis Coding Process
- Time Based Codes: 00100-01999, 90832, 90833, 90839, 90840, 95972, 95974, 95978, 97110, 99143-99150, 99291-99292, 99401-99404
- Visual Evoked Potential : 0333T, 95930.